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Wednesday, May 2, 2012

FODMAPs

If you find that after removing the fructose and fructans from your diet you are still having issues then it is time to consider whether FODMAPs is an issue. You may have already naturally eliminated these foods not realizing why they did not work for you and now as you look at this list the missing information comes together.

FODMAPs is an acronym referring to Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols.  These are a family of carbohydrates (or short-chain sugars) found in certain foods that are poorly absorbed by some people, especially those with IBS.

FODMAPs are poorly absorbed in the small intestine and this can cause increased water to be drawn into the gut, resulting in diarrhea for some people. For others, these carbohydrates move along into the large intestine without being appropriately digested, and they are fermented by the bacteria (good and bad bacteria) to produce unwanted gas.   This gas can lead to bloating and distension, flatulence, loud digestive noises, abdominal pain and nausea or can cause constipation.

Many people with IBS find that limiting their overall FODMAP intake is an effective treatment plan.

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What does it mean to limit FODMAP intake?  What do all those big words mean?  I will try to break it down

  • Oligosaccharides  - A sugar (carbohydrate) that consists of a relatively small number (three to six) of monosaccharides (the simplest form of sugar, such as fructose and glucose, that cannot be broken down to a simplier sugar and constitutes as a building block for more complex sugars)
  • Disaccharides - A sugar (carbohydrate) composed of two monosaccharides
  • Monosaccharides - the simplest form of sugar that cannot be broken down to a simplier sugar and constitutes as a building block for more complex sugars
  • Polyols – sugar alcohols, which are a type of sugar where part of their chemical structure resembles sugar, and part of it resembles alcohol

 

So if you’re like me you’re probably thinking that those definitions do not really help you any further.  So let’s see if I can break it down a bit further yet and give examples of each of these sugars

  • Oligosaccharides – fructans,  glactans, Fructo-oligosaccharides (FOS), glactooligosaccharides (GOS),
  • Disaccharides – Lactose, sucrose, maltose
  • Monosaccharides – fructose, glucose, glactose, xylose, ribose
  • Polyols – Sorbitol, Mannitol, Maltitol, Xylitol, Isomalt

Some examples of foods that have these FODMAPs and should be avoided and/or trialed properly would be:

  • Excess Fructose: Honey, Apples, Mango, Pear, Watermelon, High Fructose Corn Syrup, Corn Syrup Solids, fruit juices
  • Fructans: Artichokes (Globe), Artichokes(Jerusalem), Asparagus, Beetroot, Chicory, Dandelion leaves, Garlic (in large amounts), Leek, Onion (brown, white, Spanish, onion powder), Raddicio lettuce, Spring Onion (white part), Wheat (in large amounts), Rye (in large amounts), Inulin, Fructo-oligosaccharides (FOS).
  • Lactose: Milk, icecream, custard, dairy desserts, condensed and evaporated milk, milk powder, yoghurt, margarine, soft unripened cheeses (eg. ricotta, cottage, cream, marscarpone).
  • Galacto-Oligosaccharides (GOS): Legume beans (eg. baked beans, kidney beans, bortolotti beans), Lentils, Chickpeas
  • Polyols: Apples, Apricots, Avocado, Cherries, Longon, Lychee, Nectarines, Pears , Plums, Prunes, Mushrooms, and artificial sweeteners such as: sorbitol, mannitol, xylitol, maltitol and isomalt which are usually found in diabetic foods.

 

I’ve previously talked about fructose, fructans and foods high in these.  I’ve also talked about lactose.  Fructose and lactose are sugars that you can be tested for via breath hydrogen testing with regards to your absorption tolerance.  The other sugars do not have a test to let you know if you are malabsorbing them.  This means that the only way to truly know that you have problems with FODMAPs is to do an elimination diet.  The Elimination Diet I posted is low FODMAP.

Be careful not to assume that because you can’t eat wheat you can’t eat all fructans or because you cannot tolerate lactose that means you cannot tolerate all disaccharides.  It is still a very individual things, just like when trying to figure out the foods with fructose that you can tolerate.  While there may be some relationship, you may just as well find that there is not a connection.  Remember that serving sizes should remain small and not to eat the same foods too many days in a row.

 

Further readings about FODMAP

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